MEDICARE: STEPHANIE L. ERBER PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	8422	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0014257	OTHER	MA	NEIGHBORHOOD HEALTH PLAN
2	669494	OTHER	MA	TUFTS HEALTH PLAN

General Provider Information

NPI Number	:	1386665313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE L. ERBER PHD

Provider Business Mailing Address
First Line	:	1753 MASSACHUSETTS AVE
Second Line	:
City	:	CAMBRIDGE
State	:	MA
Zip	:	02140-2231
Country	:	US
Telephone Number	:	857-998-1681
Fax Number	:

Provider Business Practice Location Address
First Line	:	1753 MASSACHUSETTS AVE
Second Line	:
City	:	CAMBRIDGE
State	:	MA
Zip	:	02140-2231
Country	:	US
Telephone Number	:	857-998-1681
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/23/2006
Last Update Date	:	08/04/2015

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